Working with Disordered Eating in a Weight-neutral Way

Many professionals are shocked to learn that research estimates that up to 40% of people with type 2 diabetes have disordered eating patterns and even more suffer from chronic dieting. How can you, as a weight-neutral professional assist them to create peace with food and with elevated blood sugars? Using Motivational Interviewing, can help you remain nonjudgmental when your clients want to lose weight.

Client: “I need to have some surgery, but they won’t operate because of my A1C.

Professional: [Making a statement to learn what is the goal of the session you say] “You want to lower your A1C?”

Client: “I can’t take those meds. After the bypass, medicine does a number on me.”

Professional: [Making a more refined guess regarding how to lower A1C you say] “What do you want to focus on with diet?”

Client: “To improve my blood sugar. There is just a lot of foods I can’t eat.

Professionals: “You have a sense of what these foods are.”

Client: “No, not really. There are a lot of foods I can’t eat.”

Professional: “Can I learn more why you can’t eat them?” [counseling mood changes. The patient becomes emotionally uncomfortable, shifting in her chair and avoiding eye contact]

Client: [Silence]

Professional: “You want to be able to eat more foods.”

Client: “I do.” [begins to cry] “I need to eat more protein.”

Professional: [Guessing that the underlying issue is an eating disorder you make the following statement] “You suspect that your disordered eating has returned.”

Client: Looks up, eyes wide, “Can that happen?”

Professional: [Affirming the client’s thoughts, you make the following statement] “You think it has.”

Client: [The client agrees that this is the major issue] “I need help.”

To learn more about working effectively with disordered eating and diabetes care consider attending the WN4DC Symposium. The disordered eating track has been selected by ED/RD Pro founder, Sumner Brooks. If you are looking for other Motivational Interviewing options taught by RDN here is a short list: Susan Dopart, Molly Kellogg specialize in disordered eating concerns.

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